Individual provider Active NPI

Skyler Full, LCSW

  • Social Worker
  • Williamsville, NY
National Provider Identifier
1083194617
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
103337 Issued in NY
Practice address
5500 Main St Ste 204
Williamsville, NY 14221-6737
Phone
(585) 506-2087
Fax
(844) 205-8447
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 103337 NY Primary

Addresses

Primary practice location

5500 Main St Ste 204
Williamsville, NY 14221-6737

Mailing address

5500 Main St Ste 204
Williamsville, NY 14221-6737
Phone (585) 506-2087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103337NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1083194617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST STE 204",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216737",
            "telephone_number": "585-506-2087",
            "fax_number": "844-205-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST STE 204",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216737",
            "telephone_number": "585-506-2087",
            "fax_number": "844-205-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULL",
        "first_name": "SKYLER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "103337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.